Mobile Healthcare Applications Research Articles

Abstract A99: Novel method to aid clinicians and users in choosing smartphone applications for cancer prevention and management

Abstract Introduction: As the number of mobile healthcare applications expand, the task of choosing the best one becomes increasingly difficult for users and clinicians. To streamline this process, we developed a novel mobile app characterization tool that allows users and clinicians to make better-informed decisions. We use cancer as an example to demonstrate the effectiveness of our classification system. Methods: Mobile apps were identified by two key methods. First, we searched Apple's App Store and the Android Market for eight key terms. From these hits we included apps that were: (a) cancer-focused, (b) publicly available (c) targeted consumers (d) had a user rating of at least ⅗ and (e) focused on disease prevention, disease diagnosis or disease management. Second, each app was characterized according to 20 relevant features. Non-binomial variables (e.g. cost of the app) were recorded when appropriate. Results: Out of over 1200 mobile cancer apps evaluated, 25 met our inclusion criteria. Of these, only five focused on disease management and only one contained personalized user feedback. The highest scoring application overall, Cancer.net Mobile, only contained 14 of 20 relevant features. Also notably, nine of 25 cancer apps focused exclusively on breast cancer while only one focused on prostate cancer. Discussion: Thus, our system represents: (1) the first systematic approach to characterizing smartphone mobile apps related to chronic disease, (2) the first clinician and user reference tool to choosing the appropriate cancer app (3) the first systematic approach to identifying areas in need of app development. We aim to apply this system to other chronic diseases, generating a comprehensive guide for clinical decision making for mobile applications. Citation Information: Cancer Prev Res 2011;4(10 Suppl):A99.

Cross-Layer Ultrasound Video Streaming Over Mobile WiMAX and HSUPA Networks

It is well known that the evolution of 4G-based mobile multimedia network systems will contribute significantly to future mobile healthcare (m-health) applications that require high bandwidth and fast data rates. Central to the success of such emerging applications is the compatibility of broadband networks, such as mobile Worldwide Interoperability For Microwave Access (WiMAX) and High-Speed Uplink Packet Access (HSUPA), and especially their rate adaption issues combined with the acceptable real-time medical quality of service requirements. In this paper, we address the relevant challenges of cross-layer design requirements for real-time rate adaptation of ultrasound video streaming in mobile WiMAX and HSUPA networks. A comparative performance analysis of such approach is validated in two experimental m-health test bed systems for both mobile WiMAX and HSUPA networks. The experimental results have shown an improved performance of mobile WiMAX compared to the HSUPA using the same cross-layer optimization approach.

A new method of ECG feature detection based on combined wavelet transform for u-health service

The analysis of the ECG is required of accuracy for diagnosing many cardiac diseases. In this work, we propose an algorithm using wavelet transform to analyze and classify ECG (electrocardiogram) signal obtained from the developed patch type electrode. This paper presents a new combined wavelet transform artificial neural network (CWTANN) based system for classification and detection of QRS complex, P and T waves. CWTANN provided useful information for detection of cardiac disease or abnormality. In this paper, we proposed a method to detect characteristic waves, such as P, QRS and T wave from abnormal ECG signal. Daubechies, Coiflets and Symlets order 5 wavelet transform were applied to the ECG. The methods have been proven out for detection of normal signal, ventricular tachycardia (VT) and PVC (premature ventricular contraction) in the ECG through subband decomposition and combined wavelet transform. From the results, the detection rate achieved was 96.2% for off-line classification, which is indeed a good rate of accuracy for data recognition. Using the simple proposed wavelet scheme, the developed methodology achieves higher detection rates. The proposed ECG detection method can be used P, QRS, T wave detection by sum of combined scale using DWT. Thus the clinical use of the methodology is to be beneficial in the analysis of various heart diseases. The new CWTANN method is expected used in monitoring of ECG for mobile home healthcare applications.

A Risk-Based Classification of Mobile Applications in Healthcare

Mobile devices and applications are becoming popular in today’s society. The number of applications available to both the patient and the healthcare provider is changing the way healthcare is being delivered and consumed. The integration of mobile devices into every-day lives is driving the changes in healthcare. While all areas of medicine are being impacted, changes are mostly of chronic care, long term care and any place that causes a need for constant data, monitoring or training. The acceptance of mobile devices by healthcare consumers within wide range of age and socioeconomic circumstances is reason to look at mobile technology as the future of healthcare. While increased use of mobile applications are welcomed by most providers and consumers alike, there is a need to systematize the study of its use. The authors provide a framework for considering mobile applications in healthcare, based on their risk-profile. They accomplish this by first identifying and classifying the mobile healthcare applications.

A Conceptual Framework For Personalized And Mobile Health Care

The widespread adoption of cell phones and other mobile platforms represent an opportunity to extend the benefits of personalized point-of-care healthcare applications to providers and patients in the developing world. However, the challenges facing the effective deployment of mobile health care applications are complex; thus, requiring a scalable, flexible, and configurable approach. A conceptual framework based on service-oriented-architecture is proposed to address the challenges of developing and deploying mobile health care applications. A particular emphasis of the framework is a service-agent-modeling-based personalized process support that is needed to support the diverse needs of the users.

ECG와 호흡 측정이 가능한 모바일 헬스케어 의류 시스템

대부분의 모바일 웨어러블 헬스케어 모니터링 의류 시스템은 생체신호를 측정할 수 있는 센서와 데이터 취득과 무선 통신 및 제어를 담당하는 회로부, 이들을 내장하는 의복으로 구성된다. 기존의 의복형 헬스케어 시스템은 센서를 의복에 장시간 내장하기가 어렵고, 피부 접촉 시 시간에 따라 저항 값이 변화하기 때문에 장기적인 생체 신호 모니터링이 쉽지 않으며, 센서 전극과 회로 사이에 존재하는 신호선의 물리적 장애 요인도 가지고 있다. 본 연구에서는 이러한 문제점들을 해결하기 위하여, PVDF에 PEDOT 재료를 코팅하여 만든 패브릭 나노웹 ECG 전극과 PVDF 필름을 사용한 호흡 센서를 <TEX>$10\;{\mu}m$</TEX> 두께의 디지털 실을 이용하여 사용자의 의류와 일체화하였다. 탈부착이 가능한 무선 블루투스(Bluetooth) 내장 스테이션과 디지털실로 기존 의류와 일체화한 생체 신호 측정용 의류 제작을 통해, 휴대폰에서 손쉽게 심전도(ECG)와 맥박신호를 표시 할 수 있었다. Most wearable system for mobile healthcare applications consists of three parts. The first part is the sensing elements based on bio-signal, the second is the circuit module for control, data acquisition and wireless communication and control and the third is garment with a built-in electrodes and circuits. The existing healthcare garment systems have to find a solution to signal-wire and uncomfortable and inappropriate electrode to long-term attachment. Even if the wireless communication is used for healthcare garment system, the interface between sensors and circuits have to use wires. To solve these problems, this paper use electrode using PEDOT coated PVDF nanoweb for ECG signal and PVDF film sensor for respiratory signal. And, we constructed garment network using digital yarn of 10um, and transmitted ECG and respiratory signal to mobile phone through the integrated circuit with bluetooth called station To evaluate feasibility of the proposed mobile healthcare garment system, we experimented with transmission and measurement of ECG and respiratory signal using nanoweb electrode and digital yarn. We got a successful result without noise and attenuation.

Fieldwork for requirements: Frameworks for mobile healthcare applications

Ethnographic approaches to study of work in the field have been widely adopted by HCI researchers as resources for investigation of work settings and for requirements elicitation. Although the value of fieldwork for design is widely recognised, difficulties surround the exploitation of fieldwork data within the design process. Since not every development project can support or justify large-scale field investigation, the issue of how to build on previous work within a domain is particularly important. In this paper we consider this issue in the context of development of mobile healthcare applications. Many such systems will be built in the coming years, and already a number of influential studies have derived concepts from fieldwork data and used them to support analysis of healthcare work. Using a patient review process as an example, we examine how the concepts from such exemplar studies can be leveraged to analyse fieldwork data, and to facilitate requirements elicitation. The concepts, previous interpretation within the domain, prototypical requirements and associated critique together provide a framework for analysis. The concepts are used to highlight issues that must be addressed and to derive requirements. We make the case that these concepts are not “value free” and that the course of our analysis is significantly altered through the palette of concepts used. The methodological implications of this proposition are also considered.

The mHealth Stack

Applications accessible through mobile devices, such as mobile phones, are playing an increasingly important part in the delivery of high quality and personalized healthcare services. In this paper, we examine current usage of mobile devices and networks by mobile healthcare applications, and present our views on how mobile devices and networks could be used for creating patient-centered healthcare applications. The patient-centered healthcare paradigm allows for increased quality of care and quality of life for patients while increasing personal freedom to move about and be always connected to care-givers and healthcare services. The structure of our discussion is analogous to layered protocol stack in communications, progressing from the network and radio technologies, servicing middleware, cloud services, health sensors, mobile smartphones, and applications. All these layers come into play to support future mobile healthcare services.

A H-QoS-demand personalized home physiological monitoring system over a wireless multi-hop relay network for mobile home healthcare applications

For the elderly and chronic patients with cardiovascular disease who live alone, it is necessary to constantly monitor their physiological parameters, especially the electrocardiogram (ECG), to effectively prevent and control their health condition and even to provide urgent treatment or care while an emergency such as the abnormal variation of heart rate (HR) occurs. In this paper, a wireless in-home physiological monitoring system, based on multi-hop relay communications, which can ubiquitously and continuously monitor the patient's ECG at any time or any place at home without space limit and the “dead spot” due to the extended communication coverage by multi-hop wireless connectivity, is proposed. The system consists of a mobile-care device, which is responsible for capturing and wirelessly sending the patient's ECG data, a wireless multi-hop relay network (WMHRN) that is in charge of relaying the data sent by the former, and a residential gateway (RG), which is responsible for gathering and uploading the received ECG data to the remote care server through the Internet to carry out the patient's health condition monitoring and the management of pathological data. However, in order to assure that the ECG data can be effectively and timely forwarded, from the mobile-care device to the RG through the WMHRN, to meet the healthcare quality of service ( H-QoS) demand for reliable and real-time end-to-end ECG transmission, the analysis of WMHRN latency in data-forwarding stage and the deployment consideration of wireless relay nodes are investigated in detail in this work. Moreover, an emergency alert service using short message service (SMS), based on the detection of abnormal variation of HR, is also used in the RG to further enhance the healthcare service quality. A prototype of this system has been developed and implemented. Finally, the experimental results are presented to verify the feasibility of the proposed system.

Public views of mobile medical devices and services: A US national survey of consumer sentiments towards RFID healthcare technology

A 2007 national public opinion survey of 1404 Americans revealed variations in sentiments concerning the desirability of several mobile healthcare technologies based on RFID. The survey appears to be the first reasonably national public opinion survey of US adults concerning their attitudes towards mobile healthcare technology. The survey revealed high levels of interest in emergency intervention services, but much less so in health information and monitoring services. Interest in RFID personal medical technology was positively associated with high levels of trust in others and social support. At the same time, a small minority were negatively disposed towards such applications. In those cases, the negative sentiment appears heightened when the mobile healthcare application is offered in a modality attached to the body as opposed to a somewhat more physically remote option, i.e., attached to one's cell phone.

Designing e-Education Supports in e-Health Based Systems.

The inadequate availability of medical information has often made health care services in many developing countries cumbersome with enormous paper work, waste of life, time and resources, long queues, and ineffective treatment procedures. The use of mobile technology devices such as Personal Digital Assistants, Cell phone, Tablet PCs etc for health care delivery promises a revolution in modern health care. However, applications that provide access to real-time patients and research information at the point-of-care via mobile devices are at best in their low stage of adoption across the health sector. In this paper, the experience gained in designing mobile health care applications is used to proffer e-Education functionalities in the design of healthcare systems to enhance their acceptance in the medical domain. The application discussed uses, the Unified Modelling Language, mobile, and Java-based technologies for its development. The application provides a real-time access to medical information at the points of health-care delivery within health care centres.

Performance Evaluation of an Enhanced Uplink 3.5G System for Mobile Healthcare Applications

The present paper studies the prospective and the performance of a forthcoming high-speed third generation (3.5G) networking technology, called enhanced uplink, for delivering mobile health (m-health) applications. The performance of 3.5G networks is a critical factor for successful development of m-health services perceived by end users. In this paper, we propose a methodology for performance assessment based on the joint uplink transmission of voice, real-time video, biological data (such as electrocardiogram, vital signals, and heart sounds), and healthcare records file transfer. Various scenarios were concerned in terms of real-time, nonreal-time, and emergency applications in random locations, where no other system but 3.5G is available. The accomplishment of quality of service (QoS) was explored through a step-by-step improvement of enhanced uplink system's parameters, attributing the network system for the best performance in the context of the desired m-health services.

Authenticated symmetric-key establishment for medical body sensor networks

This study concerns security issues of the emerging Wireless Body Sensor Network (WBSN) formed by biomedical sensors worn on or implanted in the human body for mobile healthcare applications. A novel authenticated symmetric-key establishment scheme is proposed for WBSN, which fully exploits the physiological features obtained by network entities via the body channel available in WBSN but not other wireless networks. The self-defined Intrinsic Shared Secret (ISS) is used to replace the pre-deployment of secrets among network entities, which thus eliminates centralized services or authorities essential in existing protocols, and resolves the key transport problem in the pure symmetric-key cryptosystem for WBSN as well. The security properties of the proposed scheme are demonstrated in terms of its attack complexity and the types of attacks it can resist. Besides, the scheme can be implemented under a light-weight way in WBSN systems. Due to the importance of the ISS concept, the analysis on using false acceptance/false rejection method to evaluate the performance of ISS for its usage in the scheme is also demonstrated.

Supporting context-aware mobile applications: an infrastructure approach

Mobile phones and PDAs are converging into mobile lifestyle devices that offer a wide range of applications to end users. Many of these applications will have the ability to adapt themselves to the user's situation, commonly referred to as context awareness. We argue that an infrastructure is needed to enable wide deployment of context-aware applications. A major benefit is interoperability between heterogeneous context sources and applications in a privacy-sensitive way. We identify three main technical challenges to realize such an infrastructure: reasoning to infer higher-level and better quality context information; efficient exchange and distributed processing of context information in dynamic and pervasive environments; and end-user-controlled handling of the privacy aspects. This article explains how we address these challenges with regard to the realization of an infrastructure that supports context-aware mobile applications. We use this infrastructure to support several mobile healthcare applications

Mobile healthcare informatics

Advances in wireless technology give pace to the rapid development of mobile applications. The coming mobile revolution will bring dramatic and fundamental changes to our daily life. It will influence the way we live, the way we do things, and the way we take care of our health. For the healthcare industry, mobile applications provide a new frontier in offering better care and services to patients, and a more flexible and mobile way of communicating with suppliers and patients. Mobile applications will provide important real time data for patients, physicians, insurers, and suppliers. In addition, it will revolutionalize the way information is managed in the healthcare industry and redefine the doctor - patient communication. This paper discusses different aspects of mobile healthcare. Specifically, it presents mobile applications in healthcare, and discusses possible challenges facing the development of mobile applications. Obstacles in developing mobile healthcare applications include mobile device limitations, wireless networking problems, infrastructure constraints, security concerns, and user distrust. Research issues in resolving or alleviating these problems are also discussed in the paper.

Physician interaction with mobile and wireless handheld devices: data entry and retrieval challenges

A pro-active approach in dealing with illnesses and conditions can be supported in today's dynamic world by mobile and wireless healthcare applications. This paper first systematically presents physician communication and information needs that could be addressed by mobile and wireless solutions. However, there are a number of issues in deploying such solutions, and these are described next. Finally, we discuss several types of application requirements and their related peculiarities and difficulties from the physician's viewpoint and we address these requirements from a human-computer interaction perspective.